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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020038
Report Date: 11/09/2023
Date Signed: 11/09/2023 01:16:37 PM

Document Has Been Signed on 11/09/2023 01:16 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:AMERICAN MONTESSORI PRESCHOOL & ELEMENTARY INC.FACILITY NUMBER:
198020038
ADMINISTRATOR:NOELINE SHANMUGANFACILITY TYPE:
850
ADDRESS:4817 EAGLE ROCK BLVDTELEPHONE:
(323) 257-3709
CITY:LOS ANGELESSTATE: CAZIP CODE:
90041
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 9DATE:
11/09/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Assistant Director Vlasta BlahaTIME COMPLETED:
01:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced Required-3 year inspection at the above facility on 11/09/23 at 09:30 a.m. LPA met with lead teacher Helen Mangahis who guided LPA on a tour of the facility. Per lead teacher, Assistant Director Vlasta Blaha is not present, however, a text message was sent to notify that LPA was at the facility. Assistant director arrived at 11:03 a.m. and assisted LPA with the rest of the tour. This is a preschool age program licensed for 20 children which operates Monday – Friday from 7:00 a.m. – 5:00 p.m. Per the assistant director, there are 09 children enrolled. This facility has an infant component (LIC #198016696).

All areas identified on the Facility Sketch were inspected. Upon arrival, LPA observed 9 children with 01 staff in the Preschool Room. This facility consists of 1 preschool classroom. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded on the attached LIC859. All children were observed to be under supervision, including visual supervision, of a teacher at all times. The licensed facility is within the conditions, limitations, and capacity specified on the license.

The preschool classroom was inspected to ensure that the floors have a surface that is safe and clean. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. Drinking water was readily available indoor/outdoor via water jugs. Children bring their own water bottle and is refilled as needed. LPA observed stacks for cots stored as napping equipment in the “cubby room.” LPA observed that the children’s restroom had a strong urine smell. LPA flushed toilets and observed both toilets are functioning. LPA tested sink faucets and observed both sinks are functioning. LPA also observed the bottom of the wall has several paint chips that need to be repaired. The children’s restroom can be accessed by using the main door from the preschool classroom or from the “cubby room” (inaccessible to children) located behind the preschool classroom.
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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE: DATE: 11/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/09/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 11/09/2023 01:16 PM - It Cannot Be Edited


Created By: Veronica Martinez-Garza On 11/09/2023 at 12:17 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: AMERICAN MONTESSORI PRESCHOOL & ELEMENTARY INC.
FACILITY NUMBER: 198020038

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/09/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in LPA observed the last disaster drill documented was on 03/16/23, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/23/2023
Plan of Correction
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Per assistant director, a disaster drill will be conducted today at around 03:00 p.m. once children wake up from their nap and will submit proof to LPA by POC due date. LPA advised assitant director that disaster drills are to be conducted every 6 months.
Type B
Section Cited
CCR
101239(m)(1)
Fixtures, Furniture, Equipment and Supplies
(1) The licensee shall provide a variety of age-appropriate equipment, toys and materials in good condition and in sufficient quantity to allow children present to fully participate in planned activities.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in LPA did not observe enough play equipment for children to use, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/08/2023
Plan of Correction
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Per assistant director, some equipment will be purchased to provide a variety of age appropriate equipment to children in care and will submit proof to LPA by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Chico
LICENSING EVALUATOR NAME:Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:
DATE: 11/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/09/2023


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Document Has Been Signed on 11/09/2023 01:16 PM - It Cannot Be Edited


Created By: Veronica Martinez-Garza On 11/09/2023 at 12:17 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: AMERICAN MONTESSORI PRESCHOOL & ELEMENTARY INC.
FACILITY NUMBER: 198020038

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/09/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238(a)
Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in LPA observed the bottom of the wall has several paint chips that need to be repaired, the restroom had a strong urine smell. The 2nd door in the children’s restroom leading to the cubby room does not close all the way. The refrigerator was observed to be dirty with food crumbs, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/08/2023
Plan of Correction
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Per assistant director, the wall inside the restroom will be fixed, the restroom will be deeped cleaned to remove the urine smell, the restroom door will be fixed, and the refrigerator will be cleaned and maintained every weekend. Proof will be submitted to LPA by POC due date.
Type B
Section Cited
CCR
101238(g)
Buildings and Grounds
(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in the 2 door cabinet was fully open and Clorox wipes, Fabuloso, and other cleaning products were observed accessible to children, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/16/2023
Plan of Correction
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Per assistant director, items will be removed and the cabinet will be used to store tissues and papertowels. Proof will be sumitted to LPA by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Chico
LICENSING EVALUATOR NAME:Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:
DATE: 11/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/09/2023


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Document Has Been Signed on 11/09/2023 01:16 PM - It Cannot Be Edited


Created By: Veronica Martinez-Garza On 11/09/2023 at 12:17 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: AMERICAN MONTESSORI PRESCHOOL & ELEMENTARY INC.
FACILITY NUMBER: 198020038

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/09/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239(o)(1)
Fixtures, Furniture, Equipment and Supplies
(o) Playground equipment shall be securely anchored to the ground unless it is portable by design. (1) Equipment shall be maintained in a safe condition, free of sharp, loose or pointed parts.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in LPA observed the equipment to be dirty, spider webs, and 1 tricycle with rust, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/23/2023
Plan of Correction
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Per assistant director, the tricycle will be tossed away, spider webs will be removed, and will remind the gardener to clean the equipment. Proof will be submitted to LPA by POC due date.
Type B
Section Cited
CCR
101216(f)
Personnel Requirements
(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in S2 which is the opener for the facility does not have proof of a current Pediatric CPR/FA which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/23/2023
Plan of Correction
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Per assistant director, S2 completed a Pediatric CPR/FA class last year; however, a copy has not been placed in S2's file. Assistatn director will sumit proof of CPR/FA to LPA by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Chico
LICENSING EVALUATOR NAME:Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:
DATE: 11/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/09/2023


LIC809 (FAS) - (06/04)
Page: 4 of 8
Document Has Been Signed on 11/09/2023 01:16 PM - It Cannot Be Edited


Created By: Veronica Martinez-Garza On 11/09/2023 at 12:17 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: AMERICAN MONTESSORI PRESCHOOL & ELEMENTARY INC.
FACILITY NUMBER: 198020038

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/09/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101227(a)(6)
Food Service
(6) Menus shall be in writing and shall be posted at least one week in advance in an area accessible for review by the child's authorized representative. Copies of the menus as served shall be dated and kept on file for at least 30 days. Menus shall be made available for review by the child's authorized representative and the Department upon request.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in LPA observed that the snack menu is dated April 2023 and did not match with the snacks being provided to children, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/23/2023
Plan of Correction
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Per assistant director, menus will be updated with what the facility is currently offering to children in care and will submit proof to LPA by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Chico
LICENSING EVALUATOR NAME:Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:
DATE: 11/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/09/2023


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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: AMERICAN MONTESSORI PRESCHOOL & ELEMENTARY INC.
FACILITY NUMBER: 198020038
VISIT DATE: 11/09/2023
NARRATIVE
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 LPA observed that the 2nd door in the children’s restroom leads to the cubby room; however, the door does not close all the way. According to the assistant director, the door was recently painted, and a top right hook was removed which helped keep the door closed. The LPA observed a 2-door white storage cabinet that contained Clorox wipes and Fabuloso amongst other products that was fully accessible to children in care. LPA observed a chain lock on the cabinet handles; however, it was not locked. At this time, the "cubby room" is used as an isolation area. A cot is available for an ill child to rest on.

LPA toured the kitchen, inspected the refrigerator, and observed expired yogurt, mandarin oranges, juice box, (4) 64 oz of 100% juice, and Capri sun. The refrigerator was observed to be dirty with food crumbs. Per assistant director, the refrigerator is used by staff and only store children’s meals if necessary. Also, assistant director stated that the expired food items are not given to children since the facility provides dry snacks and fruit cups. LPA observed the assistant director discard all expired items. Snack menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. LPA observed the snack menu dated April 2023 and did not match with the snacks that were being provided to children. Snacks were reviewed for availability, quantity, and appropriateness to children in care. According to the lead teacher, the facility provides AM/PM snacks, children bring their own lunch, and at times their own snacks (parents’ choice).

All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. The facility was observed to be free of flies, other insects, and rodents.

First Aid supplies are available and complete. LPA observed a functioning carbon monoxide detector that meets statutory requirements. LPA observed a fire extinguisher located outside of the office indicates fully charged and was serviced on 02/24/23, as indicated on service tag.

At 9:50 a.m. the outdoor play equipment was inspected and observed the equipment to be outdated, dirty, spider webs, and 1 tricycle that has rust. LPA observed the swings in the back of the yard was not operational and only had 1 swing available for children to use. LPA did not observe enough play equipment for children to use. LPA also observed a flat soccer ball. Per assistant director, the soccer ball belongs to the neighbors. According to the lead teacher, the outdoor area is not in use. Outdoor areas around and/or under climbing equipment are under sand as a surface. There is adequate shade in the play yard.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2023
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: AMERICAN MONTESSORI PRESCHOOL & ELEMENTARY INC.
FACILITY NUMBER: 198020038
VISIT DATE: 11/09/2023
NARRATIVE
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Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. LPA observed 8 children were signed in, however, 9 children are present. Child 4 (C4) was not signed in. Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. C5 does not have a medical assessment on file. LPA observed all children’s files to be complete.

Staff Records were reviewed to ensure that appropriate documentation of education credits is on file. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. LPA observed Staff 2 (S2) Pediatric CPR/FA expired on 12/07/22. Per assistant director, S2 is the opener of the facility and has renewed the Pediatric CPR/FA; however, there is no record on file. LPA observed S1 does have a current Pediatric CPR/FA on file.


SB792 (Immunization Requirements for Staff and Employees) was discussed with the Director. All staff have the required immunizations on file.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018, any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2023
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: AMERICAN MONTESSORI PRESCHOOL & ELEMENTARY INC.
FACILITY NUMBER: 198020038
VISIT DATE: 11/09/2023
NARRATIVE
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at
www.cdss.ca.gov/inforesources/community-care-licensing/inspection-proces.

LPA advised the licensee to access forms, regulations, and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov

The assistant director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809D for deficiencies that are being cited and need to be cleared to protect the children’s health & safety.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Assistant Director Vlasta Blaha


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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2023
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